Abstract
Objectives: This study investigates the correlation between abnormalities detected in nailfold videocapillaroscopy and pulmonary hypertension in patients with connective tissue disease (CTD). Additionally, it explores the potential diagnostic and predictive value of nailfold videocapillaroscopy in assessing microcirculation alterations in these patients.
Methods: A cross-sectional study involving 351 CTD patients and 30 healthy controls underwent nailfold videocapillaroscopy. Two independent physicians assessed the results qualitatively, semi-quantitatively, and quantitatively. Clinical characteristics and laboratory parameters were also recorded, with a focus on differences between CTD patients with pulmonary arterial hypertension (CTD-PAH) and those without (CTD-non-PAH).
Results: Among the patients, 16.5% (n=58) had pulmonary hypertension. CTD-PAH patients showed higher nailfold videocapillaroscopy scores (5.73±3.54 vs. 4.30±2.98, P=0.001) and larger capillary diameters (17.06±8.22 vs. 14.41±9.25, P=0.044) compared to CTD-non-PAH patients. Factors significantly influencing the nailfold videocapillaroscopy score included Raynaud's phenomenon, pulmonary hypertension, and the presence of anti-Scl-70 antibody. The ROC analysis yielded an AUC of 0.621 for predicting PAH. Additionally, pulmonary artery systolic pressure in CTD-PAH patients was positively correlated with both nailfold videocapillaroscopy score (R=0.618, B=3.26, P<0.001) and capillary diameter (R=0.541, B=1.23, P<0.001).
Conclusion: Nailfold videocapillaroscopy is a valuable tool in assessing CTD patients with pulmonary hypertension, providing a novel non-invasive method for evaluating this condition.